# Population Health Department

*/Departments/Population_Health_Department*

## Neighborhood

### Related (delivered by)

- [Preventive and Chronic Care Management](/Processes/Preventive_and_Chronic_Care_Management) — delivered by · Processes
- [Preventive Screening Outreach](/Processes/Preventive_Screening_Outreach) — delivered by · Processes
- [Patient Outreach Coordination](/Processes/Patient_Outreach_Coordination) — delivered by · Processes
- [Optimize Follow Up Care](/Processes/Optimize_Follow_Up_Care) — delivered by · Processes
- [Closed Loop Follow Up](/Processes/Closed_Loop_Follow_Up) — delivered by · Processes
- [Teach or train medical staff regarding preventive medicine issues.](/Tasks/Teach_or_train_medical_staff_regarding_preventive_medicine_issues.) — delivered by · Tasks
- [Develop health management programs](/Processes/Develop_health_management_programs) — delivered by · Processes

### Processes it runs

- [Administer Immunization Programs](/Processes/Administer_Immunization_Programs) — runs · Processes
- [Disease Outbreak Investigation](/Processes/Disease_Outbreak_Investigation) — runs · Processes
- [Conduct Disease Surveillance](/Processes/Conduct_Disease_Surveillance) — runs · Processes
- [Administering Public Health Screenings](/Processes/Administering_Public_Health_Screenings) — runs · Processes
- [Promoting Community Health](/Processes/Promoting_Community_Health) — runs · Processes

### Problems this exposes

- [VFC/grant funding and public reporting ride on a coverage rate whose eligible-population denominator drifts as the attributed panel churns, penalizing the program for denominator error it can't control](/Problems/VFC%2Fgrant_funding_and_public_reporting_ride_on_a_coverage_rate_whose_eligible-population_denominator_drifts_as_the_attributed_panel_churns,_penalizing_the_program_for_denominator_error_it_can't_control) — exposes problem · Problems
- [coverage rate computed off the internal record diverges from the state immunization registry of record, so the externally-audited number understates true coverage and risks a funding clawback](/Problems/coverage_rate_computed_off_the_internal_record_diverges_from_the_state_immunization_registry_of_record,_so_the_externally-audited_number_understates_true_coverage_and_risks_a_funding_clawback) — exposes problem · Problems
- [doses administered not reconciled to the state immunization registry and ordered inventory, masking cold-chain wastage](/Problems/doses_administered_not_reconciled_to_the_state_immunization_registry_and_ordered_inventory,_masking_cold-chain_wastage) — exposes problem · Problems
- [outbreak contact-tracing surge pulls staff off screening and immunization programs, stalling routine coverage](/Problems/outbreak_contact-tracing_surge_pulls_staff_off_screening_and_immunization_programs,_stalling_routine_coverage) — exposes problem · Problems
- [notifiable-condition case reports duplicated across lab and provider feeds inflate the surveillance counts](/Problems/notifiable-condition_case_reports_duplicated_across_lab_and_provider_feeds_inflate_the_surveillance_counts) — exposes problem · Problems
- [positive screening results outrun the referral and follow-up scheduling capacity to close them](/Problems/positive_screening_results_outrun_the_referral_and_follow-up_scheduling_capacity_to_close_them) — exposes problem · Problems
- [disease-surveillance signals not linked to immunization-program coverage gaps in the same geography](/Problems/disease-surveillance_signals_not_linked_to_immunization-program_coverage_gaps_in_the_same_geography) — exposes problem · Problems
- [community-health program reach not reconciled against surveillance data showing where disease burden concentrates](/Problems/community-health_program_reach_not_reconciled_against_surveillance_data_showing_where_disease_burden_concentrates) — exposes problem · Problems
- [outbreak-investigation case data re-collected manually rather than pulled from the screening and surveillance systems](/Problems/outbreak-investigation_case_data_re-collected_manually_rather_than_pulled_from_the_screening_and_surveillance_systems) — exposes problem · Problems
- [SDOH screening (PRAPARE/AHC) captured in free-text notes that never reach the care-management queue](/Problems/SDOH_screening_(PRAPARE%2FAHC)_captured_in_free-text_notes_that_never_reach_the_care-management_queue) — exposes problem · Problems
- [closing HEDIS gap-in-care lists that arrive after the measurement-year window has already closed](/Problems/closing_HEDIS_gap-in-care_lists_that_arrive_after_the_measurement-year_window_has_already_closed) — exposes problem · Problems
- [reaching rising-risk patients before an avoidable ED visit, not after the claim posts](/Problems/reaching_rising-risk_patients_before_an_avoidable_ED_visit,_not_after_the_claim_posts) — exposes problem · Problems
- [reconciling attribution rosters from multiple payers that disagree on which PCP owns a member](/Problems/reconciling_attribution_rosters_from_multiple_payers_that_disagree_on_which_PCP_owns_a_member) — exposes problem · Problems
- [stratifying panel risk when EHR problem lists and claims lag the patient's actual acuity by months](/Problems/stratifying_panel_risk_when_EHR_problem_lists_and_claims_lag_the_patient's_actual_acuity_by_months) — exposes problem · Problems
- [care-gap outreach duplicated across disease-registry programs because diabetes, CHF, and CKD lists run in silos](/Problems/care-gap_outreach_duplicated_across_disease-registry_programs_because_diabetes,_CHF,_and_CKD_lists_run_in_silos) — exposes problem · Problems
- [rising-risk patients between high-risk and stable missed by threshold-based registries](/Problems/rising-risk_patients_between_high-risk_and_stable_missed_by_threshold-based_registries) — exposes problem · Problems
- [risk stratification of attributed panels run on stale claims rather than near-real-time data](/Problems/risk_stratification_of_attributed_panels_run_on_stale_claims_rather_than_near-real-time_data) — exposes problem · Problems
- [payer value-based-contract performance reconciled to internal numbers only at settlement](/Problems/payer_value-based-contract_performance_reconciled_to_internal_numbers_only_at_settlement) — exposes problem · Problems
- [open HEDIS/care-gap closure chased patient-by-patient against the quality registry near measurement-year end](/Problems/open_HEDIS%2Fcare-gap_closure_chased_patient-by-patient_against_the_quality_registry_near_measurement-year_end) — exposes problem · Problems
- [social-determinants screening and referral loop-closure tracked outside the EHR](/Problems/social-determinants_screening_and_referral_loop-closure_tracked_outside_the_EHR) — exposes problem · Problems
- [chart-chase abstraction for supplemental data to close measures done by nurse reviewers manually](/Problems/chart-chase_abstraction_for_supplemental_data_to_close_measures_done_by_nurse_reviewers_manually) — exposes problem · Problems
- [Closing Care Gaps In Risk Cohorts](/Problems/Closing_Care_Gaps_In_Risk_Cohorts) — exposes problem · Problems

### Measured by

- [Outbreak Containment Time](/Metrics/Outbreak_Containment_Time) — measured by · Metrics
- [Screening Participation Rate](/Metrics/Screening_Participation_Rate) — measured by · Metrics
- [Communicable Disease Incidence](/Metrics/Communicable_Disease_Incidence) — measured by · Metrics
- [Vaccination Coverage Rate](/Metrics/Vaccination_Coverage_Rate) — measured by · Metrics

### Staff

- [Disease Surveillance Specialist](/JobTypes/Disease_Surveillance_Specialist) — staff · JobTypes
- [Health Educator](/JobTypes/Health_Educator) — staff · JobTypes
- [Public Health Nurse](/JobTypes/Public_Health_Nurse) — staff · JobTypes
- [Epidemiologist](/JobTypes/Epidemiologist) — staff · JobTypes
- [Public Health Director](/JobTypes/Public_Health_Director) — staff · JobTypes

### Part of

- [County Government](/CompanyTypes/County_Government) — part of · CompanyTypes
- [Public Health Authority](/CompanyTypes/Public_Health_Authority) — part of · CompanyTypes
- [Local Government](/CompanyTypes/Local_Government) — part of · CompanyTypes